A male Hispanic/Latino patient arrives at 2:30 p.m. for a 1 p.m. appointment. Given he took several buses and lost several hours work to reach the doctor’s office, the patient feels frustrated and shunned when told that by the staff that he is late and that they will have to try to “work him in.” After traveling this far, he has no choice but to sit, wait and hope to get in.

A first year resident is assigned the responsibility of taking a medical history with an elderly male American Indian patient. The resident feels puzzled as he continues to move through the questionnaire, focusing on less sensitive questions as the patient seems reluctant to respond. Unfortunately, he is getting very few responses. The patient seems to sit quietly after each question and does not seem willing to look the intern in the eye.

A physician and his female Chinese patient from Taiwan discuss a new medication he is prescribing to address her recurrent headaches. She seems interested in his recommendations and smiles and nods her head frequently during the visit. She leaves his office with sample pills and a prescription. Despite seeming to agree with the doctor’s recommendations, she has no intention of taking the medicine or making a follow up appointment as recommended.

Situations like the above happen every day in medical practice. Undoubtedly, how medical professionals deal with such situations not only affects the quality of patient care but also contributes to health care disparities experienced regularly by minority and medically underserved patients. Though there are several underlying issues, one thing they share in common is the impact of cultural differences on clinical encounters. That is why it is important for all medical professionals to enhance their levels of cultural competence.

After reading the above descriptions, you may be thinking . . .

“How is it possible for me to take non-specific cultural factors into account with every patient?”

“With so little time to see each patient, it isn’t possible for me to worry about their culture!”

“How can I possibly learn everything there is to know about every culture?”

In this section, “General Recommendations,” we are providing you with some helpful suggestions for any clinical encounter, but which may be particularly salient in the cross cultural clinical encounter.

In the section titled “Background,” you will learn more about the many of culture and how to better understand your own cultural tendencies.

When reviewing, “Important considerations for specific populations”, you will be introduced to some generalizations that may be helpful to understand when working with specific population groups.

It is important to remember, however, that our recommendations should be considered “generalizations” and should not be used to stereotype any individual due to their membership in a given group.

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